If you smoked heavily for years, Medicare pays the full cost of an annual lung scan that can catch cancer before you feel a single symptom. That scan, a low-dose computed tomography (LDCT) screening, is covered at $0 for eligible beneficiaries under Medicare's lung cancer screening benefit, National Coverage Determination (NCD) 210.14.
For Georgia Medicare beneficiaries, lung cancer screening is one of the most consequential preventive services available. Lung cancer is the leading cause of cancer death in Georgia and the United States, and Georgia's smoking rates run higher than the national average, especially in rural south, southwest, and southeast Georgia. This guide walks through who qualifies, the required counseling visit, what the scan costs, how to read your result, and where to get screened across the state.
How Medicare Covers Lung Cancer Screening in Georgia
Medicare added annual lung cancer screening through National Coverage Determination (NCD) 210.14, issued under the Social Security Act's Section 1861(ddd) "additional preventive services" authority. That authority lets Medicare cover a preventive service when it is reasonable and necessary for early detection and carries a Grade A or B recommendation from the U.S. Preventive Services Task Force (USPSTF). Lung cancer screening carries a USPSTF Grade B recommendation, which is what brought it into Medicare coverage.
The benefit has expanded over time. Effective for dates of service on or after February 10, 2022, Medicare lowered the starting age from 55 to 50 and dropped the required smoking history from 30 pack-years to 20, aligning coverage with the updated USPSTF recommendation and widening who can be screened. If your doctor once told you that you did not qualify, it is worth asking again under the current, lower thresholds.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
One coverage limit is worth knowing up front: the USPSTF recommends screening through age 80, but Medicare's NCD 210.14 covers it only through age 77. So an adult aged 78 to 80 meets the national recommendation yet falls outside Medicare's coverage age band.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Who Qualifies for Georgia Medicare Lung Cancer Screening
To have Medicare cover an LDCT screening, you must meet all of the following:Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
- Age 50 to 77. The age 50 floor reflects the 2022 expansion; the age 77 ceiling is Medicare's judgment about where screening benefit clearly outweighs harm.
- At least a 20 pack-year smoking history. A pack-year is packs per day multiplied by years smoked. One pack a day for 20 years, two packs a day for 10 years, and half a pack a day for 40 years each equal 20 pack-years.
- A current smoker, or you quit within the past 15 years. If you quit more than 15 years ago, you are no longer eligible, because residual risk falls over time after quitting.
- No signs or symptoms of lung cancer. Screening is for people who feel fine. A persistent cough, coughing up blood, unexplained weight loss, or chest pain calls for a diagnostic CT instead, which is billed differently and carries normal cost-sharing.
- An order from your provider, which comes out of the counseling visit described next.
The Counseling and Shared Decision-Making Visit (CSDM)
Before your first LDCT, Medicare requires a counseling and shared decision-making (CSDM) visit with a doctor or qualified practitioner, billed under HCPCS code G0296. This requirement is unusual among Medicare screenings, and it exists because lung cancer screening carries real trade-offs, including false-positive findings, incidental findings, and the risks of following up on a suspicious spot.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
At the visit, your provider confirms you qualify, walks through the benefits and harms of screening using a decision aid, explains that the scan can turn up incidental findings that need follow-up, counsels you on quitting if you still smoke, and, if screening is right for you, writes the order. A nurse practitioner, physician assistant, or clinical nurse specialist can perform it within their scope of practice, and your regular primary care provider can do it.
You only need the CSDM once, before your first scan. Later annual scans need a written order but not a new counseling visit, though many providers reinforce quit-smoking and adherence messages at each yearly visit. The CSDM itself is covered at $0 under the same waiver as the scan.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
How to Get Screened for Lung Cancer in Georgia
Confirm you qualify with your provider
Bring an honest smoking history so your provider can calculate your pack-years and check the age and quit-date rules. The Annual Wellness Visit is a natural place to have this conversation.
Complete the counseling and shared decision-making visit
This required CSDM visit (HCPCS G0296) covers the benefits and harms of screening and ends with your provider writing the screening order. You pay $0.
Get your low-dose CT scan at a registry facility
The scan (HCPCS G0297) takes only a few minutes and uses far less radiation than a standard chest CT. Confirm the imaging center participates in a Medicare-approved lung cancer screening registry before you go. You pay $0.
Review your Lung-RADS result and plan any follow-up
Most results simply mean you continue annual screening. An abnormal result triggers a follow-up plan, and those follow-up services carry standard cost-sharing.
Return every year you remain eligible
The benefit is annual. Medicare covers the next scan once at least 11 full months have passed since the last one.
What the Scan Costs You
Under Section 4104 of the Affordable Care Act, Medicare waives the Part B deductible and coinsurance for USPSTF Grade A and B preventive services. Because lung cancer screening is a Grade B service, both the CSDM visit (G0296) and the annual LDCT scan (G0297) are covered at $0 when your provider accepts assignment.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
The important catch is that this waiver covers screening, not diagnosis. The moment your scan turns up something that needs a diagnostic workup, those follow-up services shift to standard Part B cost-sharing: the annual Part B deductible ($283 in 2026) and then 20% coinsurance of the Medicare-approved amount. That applies to follow-up CT scans, PET-CT, biopsies, specialist visits, and any workup of incidental findings. Your CSDM visit is the right time to ask about this so a later bill does not catch you off guard.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
| Service | HCPCS/CPT | Your cost in 2026 |
|---|---|---|
| Counseling and shared decision-making visit | G0296 | $0 (ACA Section 4104 waiver) |
| LDCT screening scan | G0297 | $0 (ACA Section 4104 waiver) |
| Follow-up diagnostic chest CT | 71260, 71270 | Part B deductible + 20% coinsurance |
| PET-CT | 78815 | Part B deductible + 20% coinsurance |
| CT-guided biopsy | 32408 | Part B deductible + 20% coinsurance |
| Bronchoscopy with biopsy | 31628 | Part B deductible + 20% coinsurance |
| Tobacco cessation counseling | G0436, G0437 | $0 (ACA Section 4104 waiver) |
If you have a Medicare Advantage plan, it must cover at least the same screening benefit as Original Medicare. If you have QMB status through a Medicare Savings Program or a Medigap policy, that coverage can pick up the cost-sharing on diagnostic follow-up.
Understanding Your Lung-RADS Result
Radiologists report LDCT findings using the Lung Imaging Reporting and Data System (Lung-RADS), a standardized scale built by the American College of Radiology (ACR). It sorts findings into categories, from a clean scan through findings highly suspicious for cancer, and each category comes with a recommended next step. Most people screened get a Lung-RADS 1 or 2 and simply keep screening each year.
| Lung-RADS category | What it means | Recommended next step |
|---|---|---|
| 0 | Incomplete | Repeat imaging or compare with prior scans |
| 1 | Negative | Continue annual screening |
| 2 | Benign appearance | Continue annual screening |
| 3 | Probably benign | Follow-up LDCT in 6 months |
| 4A | Suspicious | Follow-up LDCT in 3 months, PET-CT, or biopsy |
| 4B | Very suspicious | PET-CT and/or biopsy |
| 4X | Highly suspicious for cancer | PET-CT and/or biopsy |
LDCT also commonly turns up incidental findings unrelated to lung cancer, such as coronary artery calcium, thyroid or adrenal nodules, or emphysema. These may need their own follow-up, and that follow-up is subject to standard Part B cost-sharing.
Quitting Smoking: Medicare Tobacco Cessation Coverage
Screening works best paired with quitting, and Medicare covers help to do it. For any beneficiary who uses tobacco, Medicare Part B covers up to 8 counseling sessions in a 12-month period (structured as 2 quit attempts of up to 4 sessions each) under HCPCS codes G0436 and G0437. There is no requirement that you already be sick, and you pay $0 when your provider accepts assignment.Centers for Medicare & Medicaid Services. (n.d.). Counseling to prevent tobacco use & tobacco-caused disease - Medicare.gov. medicare.gov. Retrieved Aug 9, 2026, from https://www.medicare.gov/coverage/counseling-to-prevent-tobacco-use-tobacco-caused-disease
On medications, the split matters: Medicare Part D drug plans cover prescription-only cessation products such as bupropion and varenicline, but over-the-counter nicotine replacement therapy, including patches, gum, and lozenges, falls outside the Part D basic benefit and is not covered there. Check your specific plan's formulary for details.Centers for Medicare & Medicaid Services. (n.d.). Counseling to prevent tobacco use & tobacco-caused disease - Medicare.gov. medicare.gov. Retrieved Aug 9, 2026, from https://www.medicare.gov/coverage/counseling-to-prevent-tobacco-use-tobacco-caused-disease
In Georgia, the Georgia Tobacco Quit Line at 1-877-270-7867 offers free coaching and a quit plan to any resident, and screening programs routinely refer smokers to it.
Where to Get Screened in Georgia
Any facility performing Medicare-covered LDCT must be enrolled with Medicare and take part in a Medicare-designated lung cancer screening registry, usually the ACR Lung Cancer Screening Registry. You can verify a facility's participation through the ACR's facility locator or by asking the imaging center directly before you schedule.
Screening capacity is concentrated in Georgia's metros and regional hubs:
- Metro Atlanta: Emory, Wellstar, Piedmont, Northside, and Grady all run lung cancer screening programs with linked pulmonology and thoracic surgery.
- Augusta and east Georgia: Augusta University, through the Georgia Cancer Center.
- Macon and central Georgia: Atrium Health Navicent and Coliseum Medical Centers.
- Savannah and coastal Georgia: Memorial Health and St. Joseph's/Candler.
- Albany and southwest Georgia: Phoebe Putney Memorial Hospital.
- Athens and northeast Georgia: Piedmont Athens Regional and St. Mary's.
Many rural Georgia counties have no local LDCT site. If you live in one, your primary care provider can usually perform the CSDM locally and refer you to the nearest regional center for the scan itself. Because rural Georgia carries both higher smoking rates and higher lung cancer mortality, closing that travel gap is exactly where screening can do the most good.
Worked Examples
Example 1 (hypothetical). A 65-year-old man in Fulton County smokes a pack a day and has for 25 years, with no symptoms. At his Annual Wellness Visit, his Emory primary care doctor calculates 25 pack-years, confirms he qualifies, and performs the CSDM. He gets his first LDCT; the result is Lung-RADS 1 (negative). He pays $0 and is scheduled to return in a year.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Example 2 (hypothetical). A 70-year-old woman in Worth County smoked a pack a day for 30 years and quit 10 years ago. She still qualifies because she quit within 15 years. Her local primary care provider performs the CSDM and refers her to Phoebe Putney for the scan. The result is Lung-RADS 2 (benign-appearing nodule). She pays $0 and continues annual screening.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Example 3 (hypothetical). A 68-year-old in Cobb County with a 40 pack-year history gets an annual LDCT at Wellstar. The result is Lung-RADS 4A, an 11 mm suspicious nodule. A PET-CT and CT-guided biopsy confirm an early-stage non-small cell lung cancer, and a multidisciplinary team plans curative surgery. The screening scan was $0; the PET-CT, biopsy, and surgery carry standard Part B cost-sharing. Caught this early, the cancer is treatable, which is the entire point of screening.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Example 4 (hypothetical). A 55-year-old woman in Bibb County on Medicare through disability smoked a pack a day for 22 years and still smokes. Under the old 30 pack-year rule she would have been ineligible; under the 2022 expansion to 20 pack-years, she qualifies. Her Atrium Health Navicent provider performs the CSDM and schedules her first scan, which reads Lung-RADS 1. She pays $0.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
The people and cases above are hypothetical illustrations, not real patients.
What Can Go Wrong (and How to Avoid It)
- The counseling visit gets skipped. Without the CSDM before your first scan, Medicare may not pay. Make sure it happens first.
- The facility is not registry-approved. A scan at a non-participating center can leave you with a bill. Confirm participation before scheduling.
- A follow-up bill surprises you. Screening is $0, but a diagnostic workup is not. Ask at the CSDM what happens cost-wise if your scan finds something.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
- You screen once and stop. The benefit compounds year over year. Put next year's scan on the calendar.
- Your provider is still using the old rules. Some practices have not updated to the 2022 criteria (age 50, 20 pack-years). If you are told you do not qualify, it is worth confirming against the current thresholds.
Frequently Asked Questions
Who is eligible for Medicare-covered lung cancer screening?
You qualify if you are age 50 to 77, have at least a 20 pack-year smoking history, currently smoke or quit within the past 15 years, have no symptoms of lung cancer, and have completed the required counseling and shared decision-making visit. You must meet all of these.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
What is a pack-year?
A pack-year is packs per day multiplied by years of smoking. One pack a day for 20 years equals 20 pack-years, and so does two packs a day for 10 years.
What is the counseling and shared decision-making visit?
The CSDM (HCPCS G0296) is a required visit before your first scan. Your provider confirms you qualify, discusses the benefits and harms of screening, counsels you on quitting, and writes the screening order. You only need it once.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Does Medicare cover the cost of the screening?
Yes. Under ACA Section 4104, both the CSDM visit and the annual LDCT scan are covered at $0, with no deductible or coinsurance, when your provider accepts assignment.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
What if my scan finds something?
Findings are reported as Lung-RADS categories. Most results mean you continue annual screening. An abnormal result leads to short-interval follow-up imaging, a PET-CT, or a biopsy, depending on the category.
Is the follow-up workup covered too?
Yes, but with standard cost-sharing rather than the $0 waiver. Follow-up CT, PET-CT, biopsy, and specialist visits are subject to the Part B deductible ($283 in 2026) plus 20% coinsurance.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Aug 7, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
How often can I be screened?
Once a year. Medicare covers the next scan once at least 11 full months have passed since your last one.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
What if I quit smoking more than 15 years ago, or I am older than 77?
Either one puts you outside Medicare's coverage. Screening is covered only for current smokers or those who quit within 15 years, and only through age 77.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Aug 7, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Does Medicare Advantage cover lung cancer screening?
Yes. Medicare Advantage plans must cover at least the same benefit as Original Medicare, including LDCT screening for eligible members.
How do I find a screening facility in Georgia?
Use the American College of Radiology's facility locator, ask your primary care provider for a referral, or contact a major Georgia program directly, such as Emory, Wellstar, Piedmont, Augusta University, or Phoebe Putney.
Where to Get Help
Learn More
Find personalized help understanding your Georgia Medicare lung cancer screening coverage at brevy.com.
The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.